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Chinese Journal of Hepatology ; (12): 290-296, 2022.
Article in Chinese | WPRIM | ID: wpr-935940


Objective: To evaluate the efficacy, establish a diagnostic model, and value of ultrasound attenuation parameters (UAP) to diagnose hepatic steatosis in metabolic dysfunction-associated fatty liver disease (MAFLD) and its relevant disorders. Methods: 3770 cases were selected from the Health Examination Center of the Third Hospital of Hebei Medical University between October to December 2020. MAFLD diagnosis was based on the Asia-Pacific region MAFLD clinical diagnosis and treatment guidelines. The degree of hepatic steatosis was divided into mild, moderate and severe according to ultrasound imaging. UAP, clinical characteristic indexes, serum biochemical indexes, characteristics of hepatic steatosis and related factors were compared and analyzed in MAFLD patients and healthy controls. Logistic regression method was used to analyze the independent risk factors affecting the progression of hepatic steatosis in MAFLD to establish the diagnostic model. The clinical efficacy of UAP and the new model in diagnosing MAFLD was evaluated by the receiver operating characteristic curve (ROC). One-way ANOVA was used to compare means among multiple groups. Mann-Whitney U test was used to compare non-normally distributed measurement data between the two groups, and rank-sum test was used to compare multiple groups. χ2 test was used to compare count data between groups. Results: Among the 3 770 cases, 650 were MAFLD, with a prevalence rate of 17.24%, and the highest prevalence was 37.23% in the age group of 60-69. The prevalence rate was significantly higher in male than female (30.34% vs. 9.17%). Age-sex analysis showed that the prevalence rate in males aged 30-69 years was 38.26%, and that in females aged over 60 years was 31.94%. UAP was significantly higher in patients with MAFLD than healthy controls (278.55 dB/m vs. 220.90 dB/m, Z=-12.592, P<0.001), and an increasing trend with increased degree of hepatic steatosis (mild:257.20 dB/m, moderate:286.20 dB/m, and severe: 315.00 dB/m) were observed. The cut-off values of UAP for the diagnosis of mild, moderate and severe hepatic steatosis were 243≤UAP<258 dB/m, 258≤UAP<293 dB/m, ≥293 dB/m in MAFLD. The sensitivity and specificity were 67.20%, 93.60%, 95.90%, and 82.10%, 72.00%, and 84.80%, respectively. UAP, alanine aminotransferase and fasting blood glucose were independent risk factors for the progression of hepatic steatosis in MAFLD. The combined MAFLD classification model (UAG model) was established. The AUC of mild, moderate and severe hepatic steatosis in MAFLD were 0.906, 0.907, and 0.946, respectively, and the sensitivity and specificity were 76.50%, 82.10%, 98.00%, and 90.80%, 83.30% and 76.10%, respectively. Conclusion: MAFLD is a common disease in the general population, with a higher incidence in male and elderly female over 30 years of age. UAP can be used as a new noninvasive diagnostic technique to evaluate hepatic steatosis in MAFLD. The UAG model has a good diagnostic efficacy on MAFLD and its relevant disorders, and thus can be used as a guide for evaluating clinical diagnosis and prognosis.

Adult , Aged , Alanine Transaminase , Elasticity Imaging Techniques , Female , Humans , Liver/diagnostic imaging , Male , Middle Aged , Non-alcoholic Fatty Liver Disease/diagnostic imaging , ROC Curve , Sensitivity and Specificity , Ultrasonography/methods
Article in Chinese | WPRIM | ID: wpr-939615


Ultrasound guided percutaneous interventional therapy has been widely used in clinic. Aiming at the problem of soft tissue deformation caused by probe contact force in robot-assisted ultrasound-guided therapy, a real-time non-reference ultrasound image evaluation method considering soft tissue deformation is proposed. On the basis of ultrasound image brightness and sharpness, a multi-dimensional ultrasound image evaluation index was designed, which incorporated the aggregation characteristics of the organization. In order to verify the effectiveness of the proposed method, ultrasound images of four different models were collected for experiments, including prostate phantom, phantom with cyst, pig liver tissue, and pig liver tissue with cyst. In addition, the correlation between subjective and objective evaluations was analyzed based on Spearman's rank correlation coefficient. Experimental results showed that the average evaluation time of a single image was 68.8 milliseconds. The evaluation time could satisfy real-time applications. The proposed method realizes the effective evaluation of real-time ultrasound image quality in robot-assisted therapy, and has good consistency with the evaluation of supervisors.

Animals , Cysts , Male , Phantoms, Imaging , Swine , Ultrasonography/methods
Asian Journal of Andrology ; (6): 201-206, 2022.
Article in English | WPRIM | ID: wpr-928532


Contrast-enhanced ultrasound (CEUS) is a new form of ultrasound (US) that can dynamically display microvessels in a highly sensitive manner. The purpose of this study was to investigate the efficacy of CEUS for characterizing testicular lesions in comparison with conventional US. Forty-seven patients with testicular lesions were enrolled. The histopathology results revealed that 31 cases were neoplastic (11 cases of seminomas, 8 nonseminomatous germ cell tumors, 8 lymphomas, 2 Leydig cell tumors, and 2 nonspecific tumors), and 16 cases were nonneoplastic (8 cases of infarctions, 3 epidermoid cysts, and 5 inflammation). The indicators of shallow lobulated morphology and cystic-solid echogenicity on conventional US were suggestive of germ cell tumors. More indicators on CEUS were found to be useful for characterizing testicular lesions. All the neoplastic lesions showed hyperenhancement on CEUS. Moreover, germ cell tumors presented with heterogeneous enhancement (73.7%, 14/19), a twisted blood vessel pattern, rapid wash-in and wash-out, and peripheral rim hyperenhancement signs. Lymphoma was characterized by nonbranching linear vessel patterns (87.5%, 7/8), rapid wash-in and slow wash-out. In nonneoplastic lesions, infarction and epidermoid cysts showed no enhancement, and abscesses were observed with marginal irregular enhancement. The sensitivity, specificity, and accuracy of CEUS for differentiating between neoplastic and nonneoplastic lesions were 100%, 93.8%, and 97.9%, respectively, and these values were higher than those for conventional US (90.3%, 62.5%, and 80.9%, respectively). CEUS can sensitively reflect the microvascular perfusion in testicular lesions and offers high accuracy for characterizing them.

Contrast Media , Diagnosis, Differential , Epidermal Cyst , Humans , Lymphoma , Male , Neoplasms, Germ Cell and Embryonal/diagnostic imaging , Sensitivity and Specificity , Testicular Neoplasms/diagnostic imaging , Ultrasonography/methods
Article in Chinese | WPRIM | ID: wpr-927854


BR55 is an ultrasound contrast agent targeting vascular endothelial growth factor receptor 2,which can be used to detect tumor neovascularization and improve the diagnostic accuracy.Overseas researchers have used BR55 for human ultrasound molecular imaging,which showed good safety and tolerance.We reviewed the research progress on BR55 applied in the evaluation of tumor neovascularization from the composition,characteristics,animal experiments,and clinical studies of BR55.

Animals , Contrast Media , Humans , Microbubbles , Molecular Imaging/methods , Neovascularization, Pathologic/diagnostic imaging , Ultrasonography/methods , Vascular Endothelial Growth Factor Receptor-2/analysis
Article in Chinese | WPRIM | ID: wpr-927848


Objective To evaluate the efficacy of ultrasound and computed tomography (CT) in diagnosing cervical lymph node metastasis (CLNM) of papillary thyroid carcinoma (PTC). Methods The patients with PTC treated by surgery in the Chinese PLA General Hospital from January 2016 to January 2021 were selected for analysis.All the patients underwent preoperative ultrasound and CT examinations,the diagnostic values of which for CLNM were retrospectively analyzed. Results A total of 322 PTC patients were enrolled in this study,including 242 with CLNM and 80 with non-CLNM.The CLNM group and non-CLNM group had significant differences in age,tumor size,and maximum size of lateral CLNM (χ2=20.34,27.34,and 4.30,respectively,all P<0.001).For the central compartment,lateral compartment,and overall compartment,ultrasound diagnosis showed higher sensitivity (χ 2=82.26,P<0.001;χ2=114.01,P<0.001;χ2=82.26,P<0.001) and accuracy (χ2=20.27,P<0.001;χ2=15.56,P<0.001;χ2=44.00,P<0.001) than CT,and had no significant differences from ultrasound combined with CT (all P>0.05).However,ultrasound diagnosis had lower specificity than CT (χ2=17.01,P<0.001;χ2=21.29,P<0.001) in the central compartment and lateral compartment.Receiver operating characteristic curve analysis showed that in the central compartment,lateral compartment,and overall compartment,ultrasound diagnosis had larger AUC than CT (Z=2.99,P=0.003;Z=3.86,P<0.001;Z=4.47,P<0.001) and had no significant difference from ultrasound combined with CT (Z=1.87,P=0.062;Z=1.68,P=0.093;Z=1.61,P=0.107). Conclusions Ultrasound and CT have their own advantages in the diagnosis of central and lateral CLNM.In general,ultrasound has better performance than CT in the diagnosis of CLNM.

Humans , Lymphatic Metastasis/diagnostic imaging , Retrospective Studies , Thyroid Cancer, Papillary/pathology , Thyroid Neoplasms/surgery , Tomography, X-Ray Computed , Ultrasonography/methods
Article in Chinese | WPRIM | ID: wpr-927844


Objective To evaluate the performance of micro-flow imaging(MFI)in the differential diagnosis of benign and malignant thyroid nodules. Methods Totally 50 patients with thyroid nodules examined by conventional ultrasound,MFI,and contrast-enhanced ultrasound and confirmed by histological or cytological pathology in the First Medical Center of Chinese PLA General Hospital from May to December in 2020 were enrolled in the study.The clinical data and ultrasound images were retrospectively analyzed.A binary logistic regression model was established to evaluate the performance of the model in predicting benign and malignant thyroid nodules. Results Logistic regression showed that composition and "S-W-C" sign were independent risk factors for predicting malignant thyroid nodule.The sensitivity,specificity,and Youden index of the logistic regression model were 73.33%,80.00%,and 0.53,respectively,and the area under receiver operating characteristic curve was 0.799(95%CI=0.662-0.899). Conclusion MFI facilitates the differential diagnosis of benign and malignant thyroid nodules and has the potential to be applied in the future.

Diagnosis, Differential , Humans , ROC Curve , Retrospective Studies , Thyroid Nodule/diagnostic imaging , Ultrasonography/methods
Article in English | WPRIM | ID: wpr-927263


INTRODUCTION@#This study aimed to investigate the ultrasonographic features of paediatric acute appendicitis and incorporate them into a scoring algorithm that will quantify the risk of complications and the strength of recommendation for surgical intervention.@*METHODS@#179 patients with suspected appendicitis who had undergone ultrasonographic examination were included in this study. Based on their medical evaluation and post-surgical histopathological results, patients were categorised into confirmed appendicitis (n = 101) and non-appendicitis (n = 78) groups.@*RESULTS@#In the appendicitis group, the appendix was visualised in 66 (65.3%) patients. In cases where the appendix was not visualised, we looked out for secondary inflammatory signs, which were present in 32 (31.7%) patients. Using stepwise logistic regression, Blumberg's sign, free fluid or collection, hyperaemia, non-compressible appendix and an appendix diameter > 7 mm were found to be significant predictive factors for appendicitis. A new scoring system called POPs was developed, combining inflammatory predictors and ultrasonography findings, with an area under the receiver operating characteristic curve of 0.958 (95% confidence interval 0.929-0.986).@*CONCLUSION@#The newly developed POPs-based diagnosis scheme proved a promising alternative to existing scoring systems such as the Alvarado score. Although further calibration would be beneficial, the proposed scoring scheme is simple and easy to understand, memorise and apply in the emergency room.

Acute Disease , Appendectomy , Appendicitis/surgery , Appendix/surgery , Child , Humans , Sensitivity and Specificity , Ultrasonography/methods
Artrosc. (B. Aires) ; 29(2): 59-63, 2022.
Article in Spanish | LILACS, BINACIS | ID: biblio-1380192


Introducción: El bloqueo interescalénico se utiliza de forma estandarizada durante la cirugía mayor de hombro, sin embargo, ninguna técnica realizada por encima de la clavícula ha demostrado reducir la tasa de bloqueo del nervio frénico por debajo del 20%. El interés en buscar una prueba diagnóstica que permita identificar la afectación del nervio frénico ha ido en incremento en los últimos años y varias han sido las pruebas diagnósticas empleadas. El objetivo de este trabajo es evaluar la utilidad clínica del ultrasonido para identificar la parálisis hemidiafragmática posterior al bloqueo interescalénico para la cirugía de hombro.Materiales y métodos: estudio diagnóstico observacional prospectivo en treinta y tres pacientes programados para cirugía de hombro. Se les realizó una espirometría forzada y se evaluó el grosor del músculo diafragma. Estas determinaciones se realizaron antes y a los veinte minutos de realizar el bloqueo interescalénico.Resultados: el total de los pacientes estudiados (100%) presentó bloqueo del nervio frénico según uno o los dos métodos utilizados en este estudio para su diagnóstico. Todos los pacientes presentaron variaciones en la ratio del grosor diafragmático en el lado del bloqueo frénico por debajo de 1.2.Conclusión: la exploración ecográfica del diafragma es una gran herramienta para la examinación de una víscera cuya alteración implica graves trastornos en el paciente crítico, a su vez el índice del grosor diafragmático <1.2 puede ser de utilidad en el diagnóstico de paresia frénica asociada al bloqueo del plexo braquial a nivel interescalénico. Tipo de Estudio: Diagnóstico prospectivo. Nivel de Evidencia: II

Introduction: the interscalene block is used in a standardized way during major shoulder surgery, however, no technique performed above the clavicle has been shown to reduce the rate of phrenic nerve block below 20%. The interest for a diagnostic test to allows identifying the involvement of the phrenic nerve has been increasing in recent years and several diagnostic tests have been used. The purpose of this article is to evaluate the clinical utility of ultrasound to identify hemidiaphragmatic paralysis after interscalene block for shoulder surgery.Materials and methods: prospective observational diagnostic study in thirty-three patients scheduled for shoulder surgery. A forced spirometry was performed and the thickness of the diaphragm muscle was evaluated with ultrasound. These determinations were made before and twenty minutes after performing the interscalene block.Results: all the patients studied (100%) presented phrenic nerve block according to one or the two methods used in this study for its diagnosis. All patients presented variations in the diaphragm thickness ratio on the side of the phrenic block below 1.2.Conclusion: the ultrasound examination of the diaphragm is a great tool for the examination of a viscera whose alteration implies serious disorders in the critical patient, in turn, the diaphragm thickness index <1.2 can be useful in the diagnosis of phrenic paresis associated with interscalene brachial plexus block. Level of Evidence: II

Adult , Paralysis , Phrenic Nerve , Shoulder Joint/surgery , Ultrasonography/methods , Brachial Plexus Block , Analgesia
Int. j. cardiovasc. sci. (Impr.) ; 34(5): 523-530, Sept.-Oct. 2021. tab, graf
Article in English | LILACS | ID: biblio-1340048


Abstract Background: Fontan circulation can be associated with significant morbidity, especially Protein-Losing Enteropathy (PLE). Echocardiographic parameters can provide valuable diagnostic information about a patient's risk of developing PLE after Fontan surgery. Objectives: To describe echocardiographic/ultrasonographic parameters associated with PLE in patients after Fontan surgery through a systematic review with meta-analysis. Methods: A literature search was performed in electronic databases to identify relevant studies about echocardiographic parameters and PLE prediction in children after Fontan surgery. The search terms used were: "echocardiography", "ultrasonography", "Fontan," and "protein-losing enteropathy". A p < 0.05 was considered statistically significant. Results: A total of 653 abstracts were obtained from electronic databases and bibliographic references. From these, six articles met criteria to be included in the qualitative analysis and three in the quantitative (meta-analysis). The resistance index in the superior mesenteric artery was described in three studies, and the quantitative analysis showed statistical significance (p < 0.001). Other echocardiographic and ultrasonographic parameters were also described, albeit in single studies not allowing a meta-analysis. Conclusion: This systematic review with meta-analysis identified echocardiographic and ultrasonographic parameters related to PLE in patients with Fontan physiology. Vascular ultrasonography seems to play a prominent role in this aspect, but additional studies are needed to increase the degree of evidence.

Humans , Male , Female , Protein-Losing Enteropathies/diagnostic imaging , Fontan Procedure/methods , Echocardiography/methods , Ultrasonography/methods , Fontan Procedure/adverse effects
Rev. cuba. cir ; 60(3): e1147, 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1347386


Introducción: Dentro de la atención al lesionado con trauma torácico se cuenta con varios medios diagnósticos, entre ellos la evaluación por ecografía focalizada en trauma extendido a tórax, el cual ha mostrado una alta sensibilidad, aun realizado por médicos no radiólogos como cirujanos generales, emergencistas e intensivistas. Objetivo: Determinar la utilidad de la ecografía torácica extendida realizada por cirujanos en lesionados con traumatismo torácico. Métodos: Se realizó un estudio observacional, descriptivo de evaluación de pruebas diagnósticas con un diseño transversal, en 1052 pacientes ingresados en la sala de emergencia. Se les realizó la evaluación por ecografía torácica extendida en el Hospital Universitario "General Calixto García", durante el período comprendido entre enero de 2020 y febrero de 2021. Resultados: Fueron realizados en un periodo de 1 año un total de 1052 ultrasonidos torácicos, 221 casos fueron positivos, de ellos 81 neumotórax (7,7 por ciento) y 62 hemoneumotórax (5,9 por ciento) todos confirmados por tomografía de tórax. La edad promedio fue de 45,27 (18-97), el sexo masculino prevaleció con 772 casos (73,4 por ciento). Los mecanismos productores de trauma más frecuentes fueron: caída de altura 273 casos (26 por ciento) y trauma contuso 181 casos (17,2 por ciento). La ecografía torácica extendida obtuvo una sensibilidad de un 95,24 por ciento y una especificidad de 99,88 por ciento en el diagnóstico lesiones torácicas. Conclusiones: La ecografía torácica extendida demostró que en manos de los cirujanos generales es una herramienta confiable, segura, no invasiva, poco costosa, repetible, que permite diagnosticar rápidamente lesiones torácicas y tratarlas(AU)

Introduction: Within care for the injured patient with thoracic trauma there are several diagnostic means. For example, extended focused assessment with sonography for thoracic trauma has shown high sensitivity, even when performed by non-radiologists such as general surgeons, emergency specialists and intensivists. Objective: To determine the usefulness of extended thoracic sonography performed by surgeons on injured patients with thoracic trauma. Methods: An observational, descriptive and cross-sectional study of diagnostic tests assessment was carried out in 1052 patients admitted to the emergency room. They were assessed by extended thoracic sonography at General Calixto García University Hospital, during the period between January 2020 and February 2021. Results: A total of 1052 thoracic ultrasounds were performed in a period of one year, of which 221 cases were positive. Of them, 81 were pneumothorax (7.7 percent) and 62 were hemopneumothorax (5.9 percent), all confirmed by chest tomography. The average age was 45.27 (18-97). The male sex prevailed, with 772 cases (73.4 percent). The most frequent trauma-producing mechanisms were altitude fall, accounting for 273 cases (26 percent), and blunt trauma, accounting for 181 cases (17.2 percent). Extended thoracic ultrasound showed a sensitivity of 95.24 percent and a specificity of 99.88 percent in the diagnosis of thoracic injuries. Conclusions: Extended thoracic ultrasound showed that, in the hands of general surgeons, it is a reliable, safe, noninvasive, inexpensive and repeatable tool that allows rapid diagnosis and treatment of thoracic injuries(AU)

Humans , Thoracic Injuries/diagnostic imaging , Ultrasonography/methods , Emergency Service, Hospital , Focused Assessment with Sonography for Trauma/methods , Hemopneumothorax/diagnostic imaging , Tomography/adverse effects , Epidemiology, Descriptive , Diagnostic Tests, Routine/methods , Observational Studies as Topic
Int. j. med. surg. sci. (Print) ; 8(3): 1-14, sept. 2021. tab, ilus, graf
Article in English | LILACS | ID: biblio-1292471


The accuracy of internal organ volume estimation done with ultrasound (US) was found to be multifactorial. Hence, we aimed to describe and validate the volume assessment of ultrasound and standard volume estimation formulae for different shaped intra-abdominal organs using spleens and kidneys.Dissected cadaveric kidneys (n=25) and spleens (n=29) were scanned to obtain linear measurements and ultrasound auto-generated volumes (USV). Linear measurements were used to calculate the volumes manually with ellipsoid, prolate, and Lambert volume estimating formulae. The actual volumes (AV) of organs were obtained by the water displacement method. Volume assessment accuracy of USV and different formulae were compared by comparing bias, precision and Bland-Altman plot analysis. The US linear and volume measurement procedure was reliable with high inter and intra-observer agreements (linear: Chronbach's α=0.983 to 0.934; volumes: Chronbach's α=0.989). USV estimates were accurate with a high correlation to AV and low estimation bias (-5.9%). Also, prolate (bias=-0.75%) and ellipsoid formulae (bias=-3.75%) were reliable with a negligible bias in estimated volumes. Contrary, the Lambert formula was unreliable due to a high bias (41.6%). For all evaluated methods, the estimation error found to be related to the organ size (T=3.483; p=0.001), mainly when the assessed organ is larger than 50 ml. Also, the shape related estimation error found to be related to the volume estimation formula used.This study has validated the USV for kidney and splenic volume assessments while describing volume-calculating formula employed, organ size and shape as significant contributors for volume estimation accuracy.

Se encontró que la precisión de la estimación del volumen de órganos internos realizada con ultrasonido (US) es multifactorial. El objetivo fue describir y validar la evaluación de volumen mediante ecografía y las fórmulas estándar de estimación de volumen para órganos intraabdominales de diferentes formas utilizando bazos y riñones.Se evaluaron riñones cadavéricos disecados (n = 25) y bazos (n = 29) para obtener medidas lineales y volúmenes autogenerados por ultrasonido (USV). Se utilizaron medidas lineales para calcular los volúmenes manualmente con fórmulas de estimación de volumen elipsoide, prolate y Lambert. Los volúmenes reales (AV) de los órganos se obtuvieron mediante el método de desplazamiento de agua. Se comparó la precisión de la evaluación del volumen de USV y diferentes fórmulas comparando el sesgo, la precisión y el análisis de la gráfica de Bland-Altman. El procedimiento de medición lineal y de volumen mediante US fue confiable con alta concordancia inter e intraobservadores (lineal: α de Chronbach = 0,983 a 0,934; volúmenes: α de Chronbach = 0,989). Las estimaciones de USV fueron precisas con una alta correlación con AV y un bajo sesgo de estimación (-5,9%). Además, las fórmulas prolate (sesgo= -0,75%) y elipsoide (sesgo = -3,75%) fueron confiables con un sesgo insignificante en los volúmenes estimados. Por el contrario, la fórmula de Lambert no fue confiable debido a un alto sesgo (41,6%). Para todos los métodos evaluados, se encontró que el error de estimación estaba relacionado con el tamaño del órgano (T = 3.483; p = 0.001), principalmente cuando el órgano evaluado es mayor de 50 ml. Además, se encontró que el error de estimación de forma está relacionado con la fórmula de estimación de volumen utilizada.Este estudio ha validado el USV para evaluaciones de volumen renal y esplénico al mismo tiempo que describe la fórmula de cálculo de volumen empleada, el tamaño y la forma de los órganos como contribuyentes significativos de la precisión de la estimación de volumen.

Spleen/diagnostic imaging , Ultrasonography/methods , Kidney/diagnostic imaging , Organ Size , Spleen/anatomy & histology , Kidney/anatomy & histology
Rev. medica electron ; 43(4): 1131-1136, 2021. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1341542


RESUMEN Los defectos en la canalización de la membrana himeneal causan obstrucción del tracto genital femenino. Como consecuencia aparece hematocolpos, resultante de la acumulación y retención de secreciones cervicovaginales -sangre en útero y vagina-, ante la imposibilidad de su evacuación por la presencia de un himen imperforado. Clínicamente aparece masa abdominal, asociada con malformaciones vaginales congénitas. Se presentó el caso de una adolescente de 13 años que refirió retención urinaria, disuria, dolor y masa en hipogastrio, y ausencia de la menarquía a pesar de un desarrollo puberal en estadio Tanner III. Al realizar ultrasonido se constató sangre en el útero, debido a imperforación himeneal que se resolvió mediante himenotomía. La patología de himen imperforado con hematocolpos debe estar entre los posibles planteamientos sindrómicos de aquellas pacientes con cuadros similares; puede diagnosticarse en la Atención Primaria de Salud a partir de una detallada anamnesis y exploración física, aunque la comprobación requiere ecografía (AU).

ABSTRACT The defects in the channeling of the himeneal membrane cause obstruction in the female genital tract. As consequence hematocolpos appears, resulting from the accumulation and retention of cervicovaginal secretions -blood in the uterus and vagina-, due to the impossibility of its evacuation because of the presence of an imperforate hymen. Clinically, abdominal mass appears associated to congenital vaginal malformations. We presented the case of teenager aged 13 years that referred urine retention, dysuria, pain, had a mass in the hypogastrium, and absence of menarche in spite of a Tanner III pubertal development. An ultrasound showed blood in the uterus due to hymeneal imperforation solved through hymenotomy. The pathology of imperforate hymen with hematocolpos should be among the possible syndrome considerations in those patients with the same characteristics; it can be diagnosed in the primary health care from anamnesis and physical exploration, although the verification requires an ultrasound (AU).

Humans , Female , Hematocolpos/diagnosis , Hymen/abnormalities , Signs and Symptoms , Ultrasonography/methods , Surgical Wound/surgery , Genitalia, Female/abnormalities
Rev. cuba. med. gen. integr ; 37(2): e1398, 2021. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1352016


Introducción: El cáncer de mama se ha convertido en un verdadero desafío a la calidad y expectativa de vida de la población mundial, con un aumento considerable en su incidencia y prevalencia. Cuba cuenta, desde 1987, con un Programa de Control de Cáncer Mamario. Objetivo: Ejemplificar el estudio de un caso con linfoma no Hodgkin primario de la mama, su cuadro clínico y los medios diagnósticos utilizados. Caso clínico: Paciente femenina de 70 años de edad, color de la piel negra, que acudió al Consultorio Médico de la Familia por presentar malestar general, molestias y aumento de volumen en la mama derecha. Se le remitió a consulta de cirugía y se le realizaron estudios complementarios. Se detectó nódulo de mediana densidad, contornos parcialmente definidos, distorsión del tejido vecino, otros nódulos de menos tamaño y densidad en el cuadrante inferior interno, calcificaciones vasculares en ambas mamas. Una biopsia corrobora linfoma no Hodgkin difuso de células grandes de alto grado. Conclusiones: El linfoma primario no Hodgkin de mama es muy raro y de difícil diagnóstico clínico porque no se dispone de signos, síntomas o criterios de imagen específicos para ello. El autoexamen de mama continúa siendo el principal método de diagnóstico del cáncer de mama y aunque el examen clínico, el ultrasonido de mama y la mamografía apoyan la presunción, es la biopsia quien solo brinda la confirmación diagnóstica precisa(AU)

Introduction: Breast cancer has become a real challenge to the quality of life and to life expectancy of the world population, with a considerable increase in its incidence and prevalence. Cuba has, since 1987, a breast cancer control program. Objective: To present a case with primary non-Hodgkin's lymphoma of the breast in a 70-year-old patient, its clinical picture and the diagnostic means used. Clinical case: 70-year-old female patient, with black skin, who came to the family medical office due to malaise, discomfort and increased volume in her right breast. She was referred to surgery and complementary studies were performed. Nodule of medium density was identified, with partially defined contours, distortion of the neighboring tissue, together with other nodules of less size and density in the lower internal quadrant, and vascular calcifications in both breasts. A biopsy confirms diffuse high-grade large-cell non-Hodgkin's lymphoma. Conclusions: Primary non-Hodgkin's lymphoma of the breast is very rare and difficult to diagnose clinically because there are no specific signs, symptoms or imaging criteria for it. Breast self-examination continues to be the main method of diagnosis for breast cancer and, although clinical examination, breast ultrasound and mammography support such diagnostic presumption, it is the biopsy that only provides the precise diagnostic confirmation(AU)

Humans , Female , Biopsy/methods , Breast Neoplasms/prevention & control , Breast Neoplasms/epidemiology , Mammography/methods , Ultrasonography/methods , Breast Self-Examination/methods , Lymphoproliferative Disorders , Cuba
Rev. cuba. med. gen. integr ; 37(2): e1340, 2021. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1352017


Introducción: El cáncer de piel es el tipo de cáncer más frecuente en el ser humano, el carcinoma basocelular es el más común de todos los cánceres de piel (80-90 por ciento). Excepcionalmente producen metástasis, pero pueden causar significativa morbilidad e involucran a edades más jóvenes, se tratan con éxito mediante cirugía, radioterapia, quimioterapia y crioterapia, generalmente en el nivel secundario de salud, sin embargo, estos tratamientos no siempre son posibles o deseables. El HeberFERON® es una combinación de interferones alfa y gamma humanos recombinantes, que ha mostrado producir efectos sinérgicos en la reducción de la proliferación de varias líneas de células cancerosas, esta formulación ha sido aprobada en Cuba para el tratamiento del carcinoma basocelular. Presentación de casos: Se presentaron tres casos con diagnóstico de carcinoma basocelular, localizados en la cara, tratados con HeberFERON®, en dos casos fue observada la desaparición de la lesión al finalizar la tercera semana de tratamiento. En el tercer caso, una mujer de 84 años de edad, al finalizar el primer ciclo de tratamiento, fue reducido el tamaño de la lesión tratada y desapareció otra lesión adyacente que no recibió directamente tratamiento, la lesión residual, en esta paciente, fue valorada por ultrasonido para determinar su extensión y profundidad, en los tres casos las reacciones adversas fueron leves y transitorias. Conclusiones: El HeberFERON® es una opción efectiva y segura para el tratamiento del carcinoma basocelular en la atención primaria de salud en Cuba(AU)

Introduction: Skin cancer is the commonest type of cancer in humans. Basal cell carcinoma is the commonest of all skin cancers, accounting for 80 percent to 90 percent of all cases. Exceptionally, they metastasize, but can cause significant morbidity and involve younger ages. They are successfully treated by surgery, radiotherapy, chemotherapy and cryotherapy, mostly at the secondary level of health. However, these treatments are not always possible or desirable. HeberFERON® is a combination of recombinant human alpha and gamma interferons, which has been shown to produce synergistic effects in reducing the proliferation of several lines of cancer cells. This formulation has been approved in Cuba for treating basal cell carcinoma. Case presentation: Three cases are presented with a diagnosis of basal cell carcinoma, located on the face, treated with HeberFERON®. In two cases, the lesion was observed to disappear at the end of the third week of treatment. In the third case, an 84-year-old woman, at the end of the first cycle of treatment, the size of the treated lesion was reduced and another adjacent lesion disappeared, which did not receive direct treatment. In this patient, the residual lesion was assessed by ultrasound to determine its extension and depth. In the three cases, the adverse reactions were mild and transitory. Conclusions: HeberFERON® is an effective and safe option for treating basal cell carcinoma in primary health care in Cuba(AU)

Humans , Primary Health Care , Carcinoma, Basal Cell/diagnosis , Carcinoma, Basal Cell/drug therapy , Ultrasonography/methods , Cryotherapy/methods , Reference Drugs , Carcinoma, Basal Cell/surgery , Cuba
Rev. gaúch. enferm ; 42: e20200014, 2021. tab, graf
Article in English | LILACS, BDENF | ID: biblio-1289599


ABSTRACT Objective To describe the frequency of urinary complaints, bladder globe, and need for bladder relief catheterization according to ultrasound; to investigate the relationship between the urinary volume estimated by ultrasound and the one drained in catheterization; and to describe the relationship of patient's complaints and detection of bladder globe with the diagnosis of urinary retention. Method A cross-sectional study with clinical patients with suspected urinary retention in a tertiary hospital, conducted from February to September 2018. Urinary volume ≥500 mL in ultrasound was considered urinary retention. Results Two hundred and five evaluations were performed in 44 patients. Urinary retention was detected by ultrasound in 33.2% of the evaluations. There was a strong correlation between ultrasound and bladder catheterization. There was a higher frequency of identification of bladder globe in urinary volumes ≥300 mL. Conclusion The incidence of urinary retention was higher when ultrasound was used for the diagnosis, when compared to patient's complaint and physical examination. Ultrasound showed to be accurate in establishing urinary volume.

RESUMEN Objetivo Describir la frecuencia de las quejas urinarias, el globo vesical y la necesidad del cateterismo de la vejiga por ultrasonido; verificar la relación entre el volumen urinario estimado por ultrasonido y drenado en el cateterismo y describir la relación entre las quejas de los pacientes y la detección de globo vesical y el diagnóstico de retención urinaria. Método Estudio transversal con pacientes clínicos con sospecha de retención urinaria, realizado entre febrero y septiembre de 2018 en un hospital de nivel terciario. El volumen urinario ≥500 mL en el ultrasonido se consideró retención urinaria. Resultados Se realizaron 205 evaluaciones en 44 pacientes. La retención urinaria se detectó por ultrasonido en el 33,2% de las evaluaciones. Hubo una fuerte correlación entre el ultrasonido y el cateterismo vesical. Se registró una mayor frecuencia de identificación de globo vesical en volúmenes urinarios superiores a 300 mL. Conclusión La incidencia de la RU fue mayor cuando se empleó ultrasonografía para el diagnóstico, comparado con la queja del paciente y el examen físico. La ultrasonografía se mostró precisa en determinar el volumen urinario.

RESUMO Objetivos Descrever frequência de queixas urinárias, globo vesical e necessidade de cateterismo vesical de alívio a partir da realização da ultrassonografia; verificar relação entre volume urinário estimado pela ultrassonografia e drenado no cateterismo e descrever relação entre queixas dos pacientes e detecção de globo vesical com o diagnóstico de retenção urinária. Método Estudo transversal com pacientes clínicos com suspeita de retenção urinária, no período de fevereiro a setembro de 2018, em um hospital terciário. Volume urinário ≥500mL na ultrassonografia foi considerado retenção urinária. Resultados Realizaram-se 205 avaliações, em 44 pacientes. Detectou-se retenção urinária pela ultrassonografia em 33,2% das avaliações. Houve forte correlação entre ultrassonografia e cateterismo vesical. Verificou-se maior frequência de identificação de globo vesical em volumes urinários ≥300mL. Conclusão Incidência de retenção urinária foi maior quando a ultrassonografia foi empregada para o diagnóstico, quando comparado à queixa do paciente e exame físico. Ultrassonografia mostrou-se precisa em determinar volume urinário.

Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Physical Examination , Urinary Bladder , Urinary Retention/diagnosis , Ultrasonography/methods , Hospitals, University , Nurses , Cross-Sectional Studies , Patient Safety
Rev. medica electron ; 42(6): 2609-2620, nov.-dic. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1150041


RESUMEN Introducción: el cáncer de tiroides representa un 1% del total de todos los tipos de cáncer. Su incidencia parece aumentar un 4% cada año, y en la actualidad es el octavo cáncer más frecuente en mujeres. Se utilizan medios diagnósticos para definir que paciente operar y la estrategia terapéutica a seguir. Objetivo: evaluar el resultado de los medios diagnósticos en los pacientes operados de cáncer de tiroides. Materiales y métodos: se realizó un estudio descriptivo, retrospectivo y observacional que incluye todos los pacientes operados de cáncer tiroides en el servicio de Cirugía General del Hospital Universitario "Comandante Faustino Pérez Hernández", en el período desde enero de 1993 a diciembre del 2018. Se confeccionó una planilla pararecopilar la información para el estudio de la base de datos y los resultados se presentaron en tablas de frecuencia, números y porciento. Resultados: el cáncer de tiroides fue más frecuente en el grupo etario de 31 a 50 años, predomino el sexo femenino, la variedad histológica papilar fue la más frecuente, el ultrasonido y la citología con aguja fina aportan resultados favorables para definir la estirpe biológica de los tumores del tiroides, no comportándose de igual forma la biopsia por congelación. Conclusiones: el cáncer de tiroides es más frecuente en pacientes relativamente jóvenes, del sexo femenino y de variedad papilar. El ultrasonido y la citología con aguja fina aportan criterios beneficiosos para definir conducta terapéutica (AU).

SUMMARY Introduction: thyroid cancer represents 1% of the total of all kinds of cancer. Its incidence seems to increase 4% every year, and at the present time it is the eighth more frequent cancer in women. Diagnostic means are used to determine what patient undergoes a surgery and the therapeutic strategy to follow. Objective: to evaluate the results of the diagnostic means used in patients who undergo a thyroid cancer surgery. Materials and methods: a retrospective, descriptive, observational study was carried out including all patients who underwent a surgery of thyroid cancer in the service of General Surgery of the University Hospital ¨Comandante Faustino Perez Hernandez¨ in the period from January 1993 to December 2018. A form was elaborated to collect the information for the study of the database; the results were presented in charts of frequency, numbers and percentages. Results: the thyroid cancer was more frequent in the age group of 31 to 50 years; the female sex prevailed; the most frequent variety was the histological papillary one; ultrasound and fine needle cytology yield favourable results to define the biological stock of the thyroid cancers unlike the behaviour of the biopsy by freezing. Conclusions: thyroid cancer of the papillary variety is more frequent in relatively young, female patients. Ultrasound and fine needle cytology yield beneficial criteria to define the therapeutic behaviour (AU).

Humans , Male , Female , Thyroid Neoplasms/diagnostic imaging , Ultrasonography/methods , Patients , Cell Biology/instrumentation , Thyroid Cancer, Papillary/diagnosis
Rev. bras. oftalmol ; 79(5): 336-339, set.-out. 2020. tab, graf
Article in English | LILACS | ID: biblio-1137986


Abstract Sclerochoroidal calcifications (SC) are a rare and benign ocular condition characterized by yellow-white irregular subretinal lesions usually found in the supero-temporal arcade of the midperipheral fundus in middle-aged elderly men. We present a clinical case of a 79- year-old patient who during a fundus examination presented raised whitish nodules in the supero-temporal arcade in the right eye. After performing optical coherence tomography, ultrasound, ocular computed tomography and laboratory analysis, she was diagnosed with idiopathic sclerochoroidal calcifications The pathogenesis of sclerochoroidal calcifications remains unclear but systemic conditions should be discarded. It is important to distinguish sclerochoroidal calcifications from other conditions such as tumors.

Resumo Calcificações esclerocoroidais (SC) são uma condição ocular rara e benigna caracterizada por lesões sub-retinianas irregulares amarelo-brancas, geralmente encontradas na arcada superotemporal do fundo médio-periférico em homens idosos de meia-idade. Apresentamos um caso clínico de uma paciente de 79 anos que durante exame de fundo apresentou nódulos esbranquiçados elevados na arcada superotemporal do olho direito. Após realizar tomografia de coerência óptica, ultra-sonografia, tomografia computadorizada ocular e análise laboratorial, ela foi diagnosticada com calcificações esclerocoroidais idiopáticas A patogênese das calcificações esclerocoroidais permanece incerta, mas as condições sistêmicas devem ser descartadas. É importante distinguir calcificações esclerocoroidais de outras condições, como tumores.

Humans , Female , Aged , Calcinosis/diagnostic imaging , Scleral Diseases/diagnostic imaging , Choroid Diseases/diagnostic imaging , Tomography, X-Ray Computed/methods , Ultrasonography/methods , Clinical Laboratory Techniques/methods , Tomography, Optical Coherence/methods , Diagnosis, Differential , Metabolic Diseases
Rev. medica electron ; 42(5): 2388-2397, sept.-oct. 2020. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1144742


RESUMEN Los quistes de los conductos de Gartner, generalmente pequeños, benignos y asintomáticos, son vestigios del canal mesonéfrico de Wolff. Representan el 11 % de los quistes vaginales, esta es su localización más frecuente según la literatura consultada. Se presentó un caso operado en el Hospital Militar de Matanzas "Dr. Mario Muñoz Monroy", de localización en la cara posterior del istmo uterino (AU).

ABSTRAC Gartner's duct cyst, mostly little, benign and asymptomatic, are vestiges of the Wolffian mesonephric duct representing 11 % of the vaginal cysts; this location is the most frequently reported and published one up to date. The authors presented the case of a patient who underwent a surgery in the Military Hospital "Dr. Mario Muñoz Monroy¨ with a cyst in the posterior side of the uterine isthmus (AU).

Humans , Female , Adult , Wolffian Ducts/abnormalities , Cysts/epidemiology , Uterus/abnormalities , Wolffian Ducts/surgery , Ultrasonography/methods , Cysts/surgery , Cysts/diagnosis
Int. j. cardiovasc. sci. (Impr.) ; 33(5): 479-487, Sept.-Oct. 2020. tab, graf
Article in English | LILACS | ID: biblio-1134415


Abstract Background Lung ultrasound (LUS) can detect interstitial alveolar changes confined to the subpleural region, like those described in Covid-19. Objetive To evaluate how LUS findings correlate with chest computed tomography (CT) in patients admitted to the emergency department (ED) with suspicion of Covid-19. Methods Cross-sectional study of 20 patients (median age 43 years; interquartile range, 37-63 years; 50% male). All patients underwent LUS and chest CT on the day of ED admission. Each hemithorax was divided into 6 segments with similar landmarks, and equivalent scores (sc) of lesion severity were defined for both methods. The number of affected segments on LUS (LUSseg) was divided into tertiles (0-1, 2-5, and ≥6), and compared with number of affected segments on CT (CTseg), LUSsc, CTsc, and percentage of affected lung parenchyma through visual analysis (CTvis). ANOVA or Kruskal-Wallis test for continuous variables, chi-square test for categorical variables, and receiver operating characteristic (ROC) curve analysis to define optimal cutoff points were performed. P<0.05 was considered statistically significant. Results Median LUSsc, CTsc, CTseg, and CTvis were significantly different between groups. A clear separation between groups was demonstrated; patients with <2 affected segments on LUS were defined as low risk. The ROC curve showed good discriminative power to predict ≥6 affected segments on CT, with an area under the curve (AUC) of 0.97 and 0.98 for >7 LUSsc and >3 LUSseg, respectively. Conclusion LUS findings correlate with chest CT, and can help identify patients with normal lung or minor pulmonary involvement secondary to Covid-19. Int J Cardiovasc Sci. 2020; [online].ahead print, PP.0-0

Humans , Male , Female , Adult , Middle Aged , Tomography, X-Ray Computed/methods , Ultrasonography/methods , Cross-Sectional Studies , Triage/methods , Emergency Service, Hospital , COVID-19/diagnosis